“They begin to look like a review process more intent on preserving the welfare of the Head Injury Assessment [HIA] than the welfare of the players.”

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In the Ioane case, two independent medical reviewers questioned why the player had not been taken off for an HIA.

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However, the RFU and Premiership Rugby investigation accepted that the Sale doctor had used his clinical judgment to not remove Ioane from the field of play.

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“The Untoward Incident Reviews around HIA incidents thus far throw the system into chaos and, if they are to be believed, ask serious questions over the HIA and its suitability for the game,” Dr Stewart, a neuropathologist who has worked with World Rugby and the Scottish Rugby Union, added.

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“In each incident thus far the message seems to be ‘the process is flawless, no mistakes were made and no change or sanction is needed’.

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“This cannot all be true. That each case is an ‘incident’ must by definition either raise an issue over process or application.”